Đang chuẩn bị liên kết để tải về tài liệu:
Ebook Anorectal surgery: Part 2

Part 2 book “Anorectal aurgery” has contents: Functional anorectal disorders, anorectal malformations, fissure in ano, hemorrhoids, anorectal abscess, hidradenitis suppurativa, fistula in ano, pilonidal sinus, rectal prolapse, fecal incontinence. | Functional Anorectal ­Disorders chapter 12 A functional anorectal disorder is defined as “a variable combination of chronic or recurrent anorectal symptoms not explained by structural or biochemical abnormalities”, or in simple terms, “Anorectal symptoms, the etiology of which is currently unknown or is related to the abnormal functioning of normally innervated and structurally intact muscles, or is attributed to psychological causes”. Chronic anal or perianal pain without evident cause produces maximum mixed reactions among family, friends and physicians as compared to other disorders. Usually the result of common and easily recognized disorders such as: • Anal fissure • Anal fistula • Intersphincteric abscess • Thrombosed hemorrhoids or • Anorectal cancer. Pain in the anal canal or perineum is easily manageable, but when no cause can be found management is difficult. Often referred from one specialist to another, the patients are then offered a variety of different and yet ineffective treatments. The functional anorectal disorders are defined primarily on the basis of the symptoms. Men and women of all ages are affected by anorectal disorders. Their management is not limited to the evaluation and treatment of hemorrhoids. The spectrum of anorectal disorders ranges from benign and irritating (pruritus ani) to potentially life-threatening (anorectal cancer) disorders. Patients usually present with ‘‘constipation’’, but the clinical picture of these disorders includes: 242 Anorectal Surgery • Rectal pain and bleeding • Digitalization • Incomplete evacuation • A feeling of obstruction. Because many findings can be seen in normal patients as well, and the symptoms are nonspecific it makes the patient evaluation and diagnosis difficult. A combination of the following work-up helps arrive at the diagnosis: • Clinical picture • Defecography • Pathology • Anal tonometry (occasionally) • Pudendal terminal motor nerve latency Some of the most common anorectal